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Travel Medicine

Immunizations for Travel

Prior to departure, you should be certain that all immunizations have been accurately and completely recorded in your immunization booklet. Please keep these documents in an easily accessible place since foreign health authorities may require proof of immunization before permitting entrance into their country.

Hepatitis A — Recommended for every traveler to the developing world, unless there is evidence of immunity. Complete the hepatitis A vaccine series with a booster in 6 to 12 months. The booster is not necessary before the trip; however, the booster will probably ensure lifelong immunity.

Hepatitis B — This three-dose series is recommended for trips to countries where hepatitis B is common, or if there is a possibility of sexual or bodily fluid exposure. A hepatitis B vaccination is recommended for all children who were not vaccinated previously.

Japanese B encephalitis — Japanese B encephalitis is a potentially fatal viral illness in Southeast Asia, Korea, China, Nepal and India. The risk to tourists is estimated to be one-per-one million for short-term tourists. The vaccine is recommended for travelers spending 30 or more days in at-risk countries. Immunization consists of two vaccinations given on days 1 and 28.

Measles, mumps and rubella(MMR) — Time permitting, a booster is advised for all foreign travelers born after 1956 who have not had a physician-diagnosed case of measles or have received only one previous dose of the measles vaccine. Women of childbearing age who have not had German measles or the vaccination are advised not to become pregnant for a period of three months following the vaccination.

Meningococcal — Required for Muslim pilgrims and their families following their return from Hajj to Saudi Arabia. The vaccination is recommended for travelers to Africa.

Polio (IPV) — Polio is a viral illness that still has a foothold in parts of Asia and Africa. An injectable vaccination series is advised for all nonimmune persons, or a single booster for adults if traveling in an at-risk area.

Rabies — A regimen of three vaccinations, given on days 1, 7 and 21 or 28 is recommended for spelunkers, cyclists and others who risk the possibility of animal exposure. The series of prophylactic rabies vaccinations is not completely protective, since two additional shots are required in the event of an animal bite. Nevertheless, the prophylactic vaccination eliminates the need for the emergency administration of human rabies-immune globulin, which is often impossible to acquire in foreign countries.

Tetanus-diphtheria (Tdap) — Needed every 10 years or every 5 years if there is a likelihood of a cut or punctured wound.

Typhoid fever — Recommended for travelers going to areas where typhoid fever is common. This includes most of the developing world, specifically Africa, Asia, and South and Central America. The greatest risk exists in Asia and Latin America where environmental contamination is still a problem. There are two vaccines available. An oral typhoid vaccine (Ty21a) consists of a series of four capsules, one taken every other day, which provides protection for five years. The second vaccine is the Vi capsular vaccine (Typhim Vi), which can be administered to children 2 years of age through adulthood, with a booster dose two years later if possibility of exposure continues. The oral Ty21a vaccine can be administered to children 6 years of age and older.

Yellow fever — This live viral vaccination is required for travelers to certain parts of South America and Equatorial Africa. Yellow fever is a virus transmitted by the bite of an infected mosquito. Children 9 months of age and older require inoculation. Protection lasts 10 years, commencing 10 days after vaccination. Travelers with infants younger than 9 months of age are strongly advised against traveling to areas within a yellow fever-endemic zone. Yellow fever vaccine should never be given to infants younger than 6 months of age. Travelers 60 years and older have a higher risk of an adverse reaction.